A pilot study of salt and water restriction in patients with chronic heart failure

International guidelines recommend low sodium intake and fluid restriction for patients with chronic heart failure (CHF) despite little support from scientific research. We conducted a pilot study to evaluate if dietary restriction instructions and recommendations are effective in reducing sodium and fluid intake in patients with CHF and if such reductions affect quality of life, thirst and appetite. Design. A 12-week, prospective, randomized study with an intervention and control group. The intervention group (n=17) followed a sodium-restricted diet (2-3 g/day) and fluid restriction (1.5 L/day) while the control group (n=13) received general diet information on heart failure. Urine sodium excretion was measured on three consecutive days and para-aminobenzoic acid was used to secure urine collection. Individual dietary recommendations were provided.

Fluid intake was reduced in the intervention group compared with the control group from baseline to follow-up: 1.6(0.4)L to 1.2(0.5)L vs. 1.7(0.8)L to 1.6(0.9)L (p=0.04). Sodium excretion was reduced by > or =25% in 57% of the patients in the intervention group and in 25% in the control group (p=0.049).

Patients with CHF were able to reduce sodium and fluid intake. The effects in terms of patient perceptions and clinical outcomes need to be assessed in a larger study.